Early detection: what testing can and cannot find

Catching cancer early is one of the few things in medicine that changes outcomes. A cancer found at stage one is usually a different conversation from the same cancer found at stage four. So the instinct to test, to look, to know, is a sound one. Testing has an upside and a downside, and both matter.

Start with what is free. The NHS screens for cervical, breast and bowel cancer, offers a targeted lung scan for people at higher risk, and is introducing targeted PSA screening for men at high inherited risk, those with a BRCA2 gene change and a relevant family history. Where screening is offered, it is because the evidence shows it saves lives in that group. If you are eligible and up to date, you have already done the most valuable thing. We will tell you where you stand.

Some questions sit outside those programmes. A number of cancers have no screening test at all. Some people have a family history they want to act on, or want to look sooner, or more often. For those situations there are good tools, from a prostate MRI to a whole-body scan to a multi-cancer blood test, and the rest of this section walks through each one, including which are available now and which are not yet.

Every one of these tests has a limit. No test finds every cancer, and none gives a clean yes or no. A normal result is reassuring, not a guarantee, and it does not replace your usual screening. An abnormal result usually means more tests to find out whether anything is there, and a good number of those end in nothing, after a stretch of worry and a few more appointments. Some tests also find slow, harmless things that would never have troubled you, and acting on them can do more harm than leaving them alone.

None of that is a reason not to test. It is a reason to be clear about what a result will and will not tell you before you have it.

You decide what you want to do. The questionnaire you fill in, or a conversation with a doctor, is where the pros and cons get laid out, and where we will tell you if a different test would answer your question better. Then we arrange what you choose.

Ready to start? Choose the check that fits your question and tell us a little about yourself. A doctor reviews it, arranges what you need, and explains what it means. Most of it is done online, with the clinic there if you would rather be seen.